Medicine, Not Health Care Reform, Helps Bill Clinton Mend

Former President Bill Clinton, now in a New York City hospital room, under observation for chest pains, might be thinking to himself that it's a good thing that Clintoncare didn't pass in the early 90s. If it had, it's a safe bet that the sort of technological innovation that is keeping him alive tonight would never have advanced as far as it has. Clintoncare, after all, was about rationing; The explicit goal of that bureaucratic program was to reduce the cost of treatment, which is to say, reduce the amount of treatment. And Clinton needs more treatment, not less. As do many of us.

Moreover, Clinton, now 63, might also be quietly hoping that Obamacare never passes, either, because, as he now realizes, he is going to be a major consumer of Serious Medicine in the years ahead.

By Serious Medicine, I mean such procedures and technologies as open heart surgery, stents, and angioplasties. Those technologies barely existed a half century ago, but they are now routine. Indeed, on "NBC Nightly News," on Thursday, Robert Bazell said that a million Americans now have stents. That's a million lives saved, or at least dramatically improved.

How did all that happen? Where did this life-saving technology come from? A lot of it came from government-funded research. (Note to ardent free marketeers: Government is not the enemy.) But life-saving research came from the part of the government, i.e. the National Institutes of Health, that fosters research and even cures. It's great work that they do, and yet as we all know, the far greater government effort in recent years has been the effort for "health insurance reform." Indeed, the entire political class, on the right as well as left, seems transfixed by the issue of health care finance. But the real issue is health. And the real question, for heart disease and everything else is, "Can we cure it or not?"

By contrast, "health insurance" is simply much less important to Americans, if not to American politicos. If you have heart disease, you need treatment more than you need insurance. Both can be important, but treatment is more important. Treatment is the sine qua non--without which, nothing.

So heart patients can be grateful that others in the past cared enough to do heart research--and yet those heart patients would be even more grateful if they knew that someone was effectively researching not only treatments, but cures.

Happily, the liberal health insurance crusade keeps losing, in the 90s, and today. But we might worry that even the losing crusade might be enough to cast a shadow over medical research, for heart disease and for every other medical topic. That is, even the mere hint of government-driven rationing and price-controlling might be enough to chase venture capital into other fields, away from medicine. We'll never know for sure how much "crowding out" of medical money has taken place, but it must be substantial. That's another question for Bill Clinton to think about tonight.

And so, too, for all of us to think about. Because the bell that could be tolling for him will be tolling, as well, for every American. But better later rather sooner.